AB1049 PECULIARITIES AND COMPARISON OF 24-HOUR BLOOD PRESSURE MONITORING IN PATIENTS WITH GOUT AND OTHER FORMS OF ARTHRITIS
Authors: E. Mikhnevich, D. Homets, S. Lemiasheuskaja
Journal: Annals of the Rheumatic Diseases (2022)

Background The leading cause of death in patients with gout is cardiovascular diseases (CVD), with the mortality rate being higher as compared to that in the general population. Hypertension (HT) occurring early with gout is considered among other reasons. Current studies demonstrate a number of features of HT in gout (in contrast to patients with essential HT), which determine an unfavourable prognosis for gout. Objectives To compare the indicators of 24-hour blood pressure monitoring (24hBPM) in patients with gout and these in a group of patients with other forms of arthritis, as well as in the group of patients with essential HT. Methods The retrospective study included 162 patients hospitalized at the Rheumatology Department of the City Clinical Hospital № 11 (Minsk) from 2014 to 2021. The study group 1 (n=90) consisted of patients with gout (AKP, 1977). The comparison group 2 (n=39) included patients with other forms of arthritis different from gouty (rheumatoid arthritis – 25.6%, osteoarthritis – 60.7%, reactive arthritis – 13.7%); group 3 (n=33) – patients with essential HT. Patients from all groups were comparable in terms of gender and age (р&gt;0.05). All patients underwent 24hBPM. Results In the study group, significantly higher average systolic blood pressure (SBP) (p˂0.05) and diastolic blood pressure (DBP) values ​​were determined during night hours than in group 2 (p˂0.05). In the main group, there was also a higher time index of HT in SBP (p˂0.05) and DBP (p˂0.05) during the day and SBP during night hours (p˂0.01). The same group was characterized by a high DBP variability during the day (p˂0.01) and night hours (p˂0.01). In addition, in patients with gout, increased values ​​(p˂0.01) and rate (p˂0.01) of the morning rise in DBP were more common. When compared to group 3, patients with gout had higher daytime SBP profiles (p˂0.01) and DBP (p˂0.01), nocturnal SBP profiles (p˂0.05), as well as high hypertensive time index (HTI) at the day (SBP, DBP, p˂0.01) and night hours (SBP, p˂0.01). The variability of BP in patients of the compared groups did not differ (p&gt;0.05). When assessing the degree of nocturnal decline (DND) in all studied groups, impaired daily SBP and DBP profile was revealed. The proportion of patients with normal DND in SBP (dippers) in all three groups was comparable (p&gt;0.05). In turn, the number of DBP dippers in the main group was less than in group 2 (x 2 =6.66; p˂0.01). Thus, DND disorders according to DBP were more common (х 2 =7.56; р˂0.01) in the study group. In the gout group, the following features were significantly more common than in group 2: obesity (x 2 =15.3; OR=2.92; CI95% 2.30-3.70 p˂0.001), CKD with GFR&lt;60 ml/min/1.73 m 2 (CKD-EPI) (x 2 =4,93; OR=2.31; CI 95% 1.87-2.86; p˂0.05), and hyperuricemia (x 2 =68.08; OR=41.7; CI 95%;23.2-74.4 p&lt;0.001). Conclusion In patients with gout, 24hBPM parameters testify to a more severe course of HT than that in other forms of arthritis and essential HT. Contributing factors may include obesity, CKD with GFR&lt;60 ml/min and hyperuricemia. All this requires more active strategy in the treatment of early detected HT in patients with gout and rational hypouricemic therapy already at the first gout attack in patients with concomitant HT. Disclosure of Interests None declared